AcknowledgementsShelter Surveillance Work
Group and Exercise Planning Team
Participants – that’s you!
Funding
Thank you!Manchester Health
Department for letting us use their space
American Red Cross for providing refreshments
Healthy NH SheltersExercise BriefingOctober 29, 2014Manchester Health Department
Exercise Scope: tabletop; 2 hours
Mission area: Response
Objectives and Public Health Preparedness Capabilities
Exercise Objective Core CapabilityIdentify the roles and responsibilities of the participating agencies during health surveillance in mass care shelters.
PHP Capability 1: Community Preparedness;
HP Capability 1: Healthcare System Preparedness
Identify all existing laws, plans, policies and procedures related to health surveillance in shelters and how they can be coordinated for a more efficient response.
PHP Capability 7: Mass Care
Exercise Objective Core Capability
Evaluate the guidance, policies, and protocols to implement health surveillance in mass care shelters.
PHP Capability 7: Mass Care;
PHP Capability 13: Public Health Surveillance and Epidemiological Investigation
Evaluate communication flow and information sharing between the shelters, the SEOC and the NH DHHS ICC/DPHS.
PHP Capability 3: Emergency Operations Coordination;
PHP Capability 6: Information Sharing
Assist the shelter with identifying and implementing infection prevention and control measures for the shelter.
PHP Capability 13: Public Health Surveillance and Epidemiological Investigation
Participant Roles and ResponsibilitiesPlayers: Respond to situation presented
based on current plans, policies, and procedures
Observers: Support players in developing responses, but do not participate in moderated discussion
Facilitators: Provide situation updates and moderate discussions
Evaluators: Observe and document player discussions
Exercise Guidelines This is an open, low-stress, no-fault
environment. Varying viewpoints, even disagreements, are expected.
Base your responses on the current plans and capabilities of your organization.
Decisions are not precedent setting; consider different approaches and suggest improvements.
Issue identification is not as valuable as suggestions and recommended actions that could improve efforts; problem-solving efforts should be the focus.
Assumptions and Artificialities The exercise is conducted in a no-
fault learning environment wherein capabilities, plans, systems, and processes will be evaluated
The exercise scenario is plausible, and events occur as they are presented
All players receive information at the same time
Module 1 Objectives (30 mins) Identify the roles and
responsibilities of the participating agencies during health surveillance in mass care shelters.
Identify all existing laws, plans, policies and procedures related to health surveillance in shelters and how they can be coordinated for a more efficient response.
10/22/14 In the news……
ISIS Using Chemical Weapons?
Ebola Quarantine Rules
Will Hawaii’s Volcanic Menace Stop?
10/22/14 – Weather Forecast A major storm with torrential
downpours and heavy winds is expected to hit NH
Worry about power outages and flooding
With Halloween around the corner the storm was nicknamed the Headless Horseman
DiscussionWhat is your agencies role pre-event when bad weather is coming?
Is there anything being done to pre-designate or set-up shelters?
10/23/14 Multiple vehicle
accidents across state 1 fatality; 5 sent to the
hospital
One person sent to the hospital after trying to clear a fallen tree from his driveway
10/24/14 – after the storm DPW starts to
clear the damage
Flash flood warning goes into effect
Power is out to 300,000 people across NH
10/24/2014 – Shelter Granite State High
School opens a shelter for residents, pets and individuals with functional needs
It is run by the municipality with help from the Public Health Region
DiscussionWhat is your agencies role in
setting up, running or assisting shelters during emergencies?
How can your agency help with surveillance in shelters?
DiscussionAre there
existing laws, plans, policies or procedures that can assist with conducting surveillance in shelters?
Surveillance in SheltersWhen does the surveillance
process start for shelters?
Should any of the surveillance forms be started prior to opening a shelter?
Module 2 Objectives (70 mins) Evaluate the guidance, policies, and
protocols to implement health surveillance in mass care shelters.
Evaluate communication flow and information sharing between the shelters, the SEOC and the NH DHHS ICC/DPHS.
Assist the shelter with identifying and implementing infection prevention and control measures for the shelter.
10/25/14 Power outages
expected to be out for approximately 7-10 days
Flooding severe in some places and people can’t return home
10/25/14Both shelters are filling up
quicklyGranite State High School
shelter 120 residents 30 volunteers/staff during the day 15 volunteers/staff at night 1-2 medical staff available each
shift
Granite State High School
Number Category Numbe
r Category
68 Females 52 Males
35 Families w/o children
14 Families w/children
1 Service Dogs 10People with durable medical equipment
2 Group Home adult residents
2 Group Home staff
30 Shelter staff – day shift
15 Shelter staff – night shift
Discussion Who oversees surveillance and
infection control in shelters?
Who would be tasked to contact the state to report outbreaks or communicable diseases?
Who is responsible for triage at the shelter?
DiscussionWhat
communication pathways exist between shelters (including ARC shelters) and the state?
10/25/14 Granite State High School is working with
the municipality and giving updates on shelter counts and issues to the LEOC
Shelter mentions that they may need help with medical supplies for some of the residents from the group home
The residents from the group home brought some yummy delicious Halloween cupcakes they made before the storm hit and shares them with everyone….they are so nice!
SEOC to GSHS The SEOC ESF-8
reaches out to the GSHS to check-in and asks if they have started to conduct surveillance using the forms
GSHS didn’t know they were supposed to fill out forms
DiscussionHow can the GSHS access the
forms?
What can the SEOC do to assist the shelter?
How can the shelter get the forms to the SEOC daily?
DiscussionWho keeps track of the
summary forms and monitors for trends?
If a possible outbreak is identified, who assists?
10/26/14 – 10/28/14 GSHS has been
filling out the summary form and sending it to the NH DHHS ICC email address daily
10/28/14 – Concord, we have a problem
10/2
6/20
14
10/2
7/20
14
10/2
8/20
14
10/2
9/20
140
2
4
6
8
10
12
14
5
12
1
VomitingDiarrheaFever
Discussion What additional information is
needed from the shelter?
What measures are given to the shelter to try to stop the outbreak?
What actions should have been taken before this started to prevent it?
Back to the cupcakes… Two of the ill residents are
from the group home and one of the ill residents is a staff person from the group home.
Investigation reveals that all the ill residents ate the cupcakes
One resident is transported to the hospital for dehydration and test results point to norovirus
American Red Cross Shelter If this same situation happened at
an ARC shelter: Who is notified?
Who is in charge of notifying the state of an outbreak situation?
What ARC resources are available to help mitigate the situation?